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Human immunodeficiency virus infection 

Human immunodeficiency virus infection
Chapter:
Human immunodeficiency virus infection
DOI:
10.1093/med/9780198729228.003.0077
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date: 19 November 2019

World Health Organization and UNAIDS estimated that, in 2012, there were about 35.3 million people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (about two-thirds living in sub-Saharian Africa), including 3.3 million children under 15 years of age. An increase from previous years was observed, as more people (about 10 million by 2013) are receiving the lifesaving antiretroviral therapy. There were 2.3 (1.9–2.7) million new HIV infections globally, showing a 33% decline in the number of new infections from 3.4 (3.1–3.7) million in 2001. At the same time, the number of AIDS deaths is also declining, with 1.6 (1.4–1.9) million AIDS deaths in 2012, down from 2.3 (2.1–2.6) million in 2005. As a result of scaled-up HIV prevention services, the annual number of newly infected children in 2012 was 260 000 (230 000–320 000) in low- and middle-income countries, with a 52% decline from 2001 to 2012. The introduction of universal routine antenatal HIV testing and the use of combination antiretroviral therapy in pregnancy have reduced the vertical transmission rate in Europe to less than 1%. The chapter addresses issues related to the diagnosis, clinical presentation, and management of children with HIV infections. Therapy for specific opportunistic and other infections is discussed, including pneumocystis pneumonia prophylaxis, tuberculosis, and immunization strategies, with reference to World Health Organization guidelines. Updated guidance on antiretroviral therapy are outlined, and specific references to the 2014 Paediatric European Network for the Treatment of AIDS (PENTA) guidelines on the use of antiretroviral therapy are provided.

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